August 1, 2019

Vaccines research

Kaiser Permanente scientists who study vaccination have published findings that have been cited more than 50 times in recent guidelines and consensus statements.

This brief summarizes the contributions of Kaiser Permanente Research since 2007 on the topic of vaccines. This includes vaccinations delivered in early childhood as well as those delivered to adolescents and adults.

Although the development of vaccinations against communicable diseases dates back to the 18th century, the creation of modern vaccines and their widespread use in the United States began in the 20th century.1 Today, the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) provides national recommendations for 15 vaccines, including pertussis (whooping cough), shots for pregnant women, and numerous vaccinations delivered to children, adolescents, and adults (see figure below).2 Although vaccination has largely eliminated diseases such as measles and rubella in the United States,1 these and others are still found frequently in countries with lower rates of vaccine coverage,3 and the ease of global travel has led to cases in which unvaccinated persons from developed nations have contracted these infections.4 Moreover, diseases such as pertussis,1 varicella (chicken pox),5 and human papillomavirus (HPV)6 still occur frequently in the U.S.


Publications related to vaccines since 2007

513 Journal Articles, 123 Practice Guideline References (a), 12,800 Citations (b), 83 Clinical Decision Aid References (c)

ource: Kaiser Permanente Publications Library and PLUM metrics, as of June 17, 2019.

a. Number of citing journal articles, according to Scopus.
b. Number of references in PubMed guidelines.
c. Citations in DynaMed Plus, a point-of-care clinical reference tool.

In addition to the direct effect of immunizing patients against dangerous diseases, vaccination also benefits society more broadly through so-called “herd immunity” effects. Through herd immunity, higher rates of effective vaccination for a given illness at a population level confer protection to unvaccinated individuals by making encounters with infected individuals increasingly rare. For example, increased uptake of the pediatric pneumococcal vaccine has been associated with decreased rates of the disease among adults, many of whom have not, until recently, received this vaccine.7,8 The level of vaccination coverage required to create herd immunity to a given disease depends on both the vaccine’s effectiveness and how easily the disease is transmitted between unvaccinated persons.

Vaccination is an active area of study for Kaiser Permanente Research. Scientists across the Program have used our rich, comprehensive, longitudinal data to advance knowledge in the areas of understanding risk, improving patient outcomes, and translating research findings into policy and practice. We have published more than 500 articles related to vaccines since 2007. Together, these articles have been cited nearly 13,000 times. 

These articles are the product of observational studies, randomized controlled trials, meta-analyses, and other studies led by Kaiser Permanente scientists. Our unique environment, which includes our fully integrated care and coverage model, lets our research scientists, clinicians, medical groups, and health plan leaders collaborate to contribute generalizable knowledge on vaccines, and many other topics of research.



  1. Ventola CL. Immunization in the United States: Recommendations, Barriers, and Measures to Improve Compliance: Part 1: Childhood Vaccinations. P t. 2016;41(7):426-436.
  2. Centers for Disease Control and Prevention. ACIP Vaccine Recommendations. 2018; Accessed July 6, 2018.
  3. World Health Organization. Global Alliance for Vaccines and Immunization (GAVI). 2018; Accessed July 6, 2018.
  4. Gautret P, Botelho-Nevers E, Brouqui P, Parola P. The spread of vaccine-preventable diseases by international travellers: a public-health concern. Clin Microbiol Infect. 2012;18 Suppl 5:77-84.
  5. Centers for Disease Control and Prevention. Monitoring the Impact of Varicella Vaccination. 2016; Accessed July 6, 2018.
  6. Centers for Disease Control and Prevention. Human Papillomavirus (HPV) Statistics. 2017; Accessed July 6, 2018.
  7. Stephens DS, Zughaier SM, Whitney CG, et al. Incidence of macrolide resistance in Streptococcus pneumoniae after introduction of the pneumococcal conjugate vaccine: population-based assessment. Lancet. 2005;365(9462):855-863.
  8. Whitney CG, Farley MM, Hadler J, et al. Decline in invasive pneumococcal disease after the introduction of proteinpolysaccharide conjugate vaccine. N Engl J Med. 2003;348(18):1737-1746.